Birth planning decisions.

Decisions about having a child or undergoing sterilization are complex and difficult to make. This paper proposes a counseling technique for helping couples decide whether or not they want to have a (another) child. Based upon behavioral decision theory, a hierarchy of birth planning values (Table 1) has been developed' and used to study motivations for and against childbearing as a function of family size,2 as well as to predict actual childbearing decisions.3 Using the hierarchy, it is possible for a couple to examine the costs and benefits associated with the decision to have or not to have a child. Whatever may be the values being focused upon during the decision, it is assumed the individual will choose that alternative which offers him or her the maximum possible perceived benefit. The following two case histories serve to illustrate the use of the hierarchy in birth planning counseling.